Non-conventional Risk Factors Research Articles

Evolving Concepts of the SCORE System: Subtracting Cholesterol from Risk Estimation: A Way for a Healthy Longevity?

The role of cholesterol, mainly low-density lipoproteins (LDL-C), as a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) is now established and accepted by the international scientific community. Based on this evidence, the European and American guidelines recommend early risk stratification and "rapid" achievement of the suggested target according to the risk estimation to reduce the number of major cardiovascular events. Prolonged exposure over the years to high levels of LDL-C is one of the determining factors in the development and progression of atherosclerotic plaque, on which the action of conventional risk factors (cigarette smoking, excess weight, sedentary lifestyle, arterial hypertension, diabetes mellitus) as well as non-conventional risk factors (gut microbiota, hyperuricemia, inflammation), alone or in combination, favors the destabilization of the atherosclerotic lesion with rupture/fissuration/ulceration and consequent formation of intravascular thrombosis, which leads to the acute clinical manifestations of acute coronary syndromes. In the current clinical practice, there is a growing number of cases that, although extremely common, are emblematic of the concept of long-term exposure to the risk factor (LDL hypercholesterolemia), which, not adequately controlled and in combination with other risk factors, has favored the onset of major cardiovascular events. The triple concept of "go lower, start earlier and keep longer!" should be applied in current clinical practice at any level of prevention. In the present manuscript, we will review the current evidence and documents supporting the causal role of LDL-C in determining ASCVD and whether it is time to remove it from any score.

Risk factors for severity in seasonal respiratory viral infections and how they guide management in hematopoietic cell transplant recipients.

Seasonal respiratory virus infections (RVIs) often progress to severe diseases in hematopoietic cell transplant (HCT) recipients. This review summarizes the current evidence on risk factors for the severity of RVIs in this high-risk population and provides clinical management. The likelihood of the respiratory viral disease progression depends on the immune status of the host and the type of virus. Conventional host factors, such as the immunodeficiency scoring index and the severe immunodeficiency criteria, have been utilized to estimate the risk of progression to severe disease, including mortality. Recent reports have suggested nonconventional risk factors, such as hyperglycemia, hypoalbuminemia, prior use of antibiotics with broad anaerobic activity, posttransplant cyclophosphamide, and pulmonary impairment after RVIs. Identifying novel and modifiable risk factors is important with the advances of novel therapeutic and preventive interventions for RVIs. Validation of recently identified risk factors for severe RVIs in HCT recipients is required. The development of innovative interventions along with appropriate risk stratification is critical to improve outcomes in this vulnerable population.

Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention?

Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD.

An In-Depth Prospective Comprehensive View on Myocardial Infarction (MI) in Young Adults.

Due to major advancements in myocardial infarction (MI) prevention and effective medical treatment, the death rate and incidence of MI have dropped considerably. We know that their risk factors and prognosis may differ; therefore, increasing primary and secondary prevention activities among young people is crucial. Multiple studies have found that MI is the deadliest form of coronary heart disease (CHD). As a result, we made an effort to illuminate MI in young people in our review of the literature. We found that young people, particularly women, are developing MI. Smoking is a key risk factor that should be targeted in an effort to minimize youth MI rates. It is thus important to create superior methods for measuring risk in young people, which may combine both standard and nonconventional risk factors, such as genetic rate scores and coronary artery calcium testing. Henceforth, addressing modifiable risk factors at a younger age has the greatest impact.

ATTITUDE TO HEALTH, PREVENTION AND MEDICAL CARE: GENDER ASPECT

Recent studies have been focused on studying new relationships that demonstrate associations of non-conventional risk factors for cardiovascular diseases in female populations, not only from the standpoint of a possible reduction in cardiovascular risks, but also the search for new technologies for preventive intervention, involving the study of the influence of parameters that reflect the attitude of the population to health, prevention and medical care. At the same time, the number of such studies at the population level, especially on the territory of the Russian Federation, is currently rare. However, their demand due to the consistently high levels of cardiovascular morbidity and mortality in the world and in Russia is obvious and is positioned by leading cardiologists and epidemiologists.

Evolving concepts in the pathophysiology of atherosclerosis: from endothelial dysfunction to thrombus formation through multiple shades of inflammation

Atherosclerosis is the anatomo-pathological substrate of most cardio, cerebro and vascular diseases such as acute and chronic coronary syndromes, stroke and peripheral artery diseases. The pathophysiology of atherosclerotic plaque and its complications are under continuous investigation. In the last 2 decades our understanding on the formation, progression and complication of the atherosclerotic lesion has greatly improved and the role of immunity and inflammation is now well documented and accepted. The conventional risk factors modulate endothelial function determining the switch to a proatherosclerotic phenotype. From this point, lipid accumulation with an imbalance from cholesterol influx and efflux, foam cells formation, T-cell activation, cytokines release and matrix-degrading enzymes production occur. Lesions with high inflammatory rate become vulnerable and prone to rupture. Once complicated, the intraplaque thrombogenic material, such as the tissue factor, is exposed to the flowing blood, thus inducing coagulation cascade activation, platelets aggregation and finally intravascular thrombus formation that leads to clinical manifestations of this disease. Nonconventional risk factors, such as gut microbiome, are emerging novel markers of atherosclerosis. Several data indicate that gut microbiota may play a causative role in formation, progression and complication of atherosclerotic lesions. The gut dysbiosis-related inflammation and gut microbiota-derived metabolites have been proposed as the main working hypothesis in contributing to disease formation and progression. The current evidence suggest that the conventional and nonconventional risk factors may modulate the degree of inflammation of the atherosclerotic lesion, thus influencing its final fate. Based on this hypothesis, targeting inflammation seems to be a promising approach to further improve our management of atherosclerotic-related diseases.

Analysis of Conventional and Nonconventional Risk Factors, Clinical Profile and Angiographic Correlation in Young Myocardial Infarction at Tertiary Care Centre

Background: CAD in the young require special attention as the clinical profile, risk factors and prognosis are different from that in older patients. Method: The present study is an attempt to evaluate acute myocardial infarction in young individuals (<40 years of age) undergoing coronary angiography (CAG). A total of 290 patients aged 40 years or younger who underwent CAG in the Department of Cardiology, Coimbatore medical college hospital between December 2019 to February 2021 were included in this study. Demographic characteristics, risk factor profile, laboratory test results, ECG and echocardiographic findings, CAG findings, and in-hospital mortality were as­sessed. All subjects completed the Hospital Anxiety and Depression Scale (HADS) to assess anxiety levels or presence of depressive symptoms as a potential risk factor among young patients. Results: The mean patient age was 35.6 ± 4.4 years. Men made up 87.2% of the study sample. STEMI was present in 84 % of acute MI while remaining had NSTEMI. CHF (Killip class II or III) was present at hospital admission 14.4% patients. Angiographically normal coronary arteries were found in 4% of patients with the diagnosis of ACS. The most common location of significant atherosclerotic coronary lesions was the left anterior descending artery (60.1%) followed by the right coronary artery (32.4%). The most prevalent were conventional cardiovascular risk factors followed by anxiety/depression, a family his­tory of CAD. The findings showed that 32% of the respondents had anxiety caseness and 40% had depression caseness. Conclusion: Significant risk of CHF on presentation and STEMI most common cases. Modifiable risk factors constitute primary etiology with less commonly evaluated cause as anxiety and depression need to be monitored regularly, provide regular counselling services. 4.0% revealing normal coronaries suggesting microvascular dysfunction important process other than atherosclerosis. Keywords: [young MI, nonconventional risk factors, STEMI, coronary angiogram]

Age-dependent associations of risk factors for cardiovascular diseases with the state of cognitive functions

The aim of the study was to provide a population assessment of cognitive impairment patterns in a representative sample of 25–44 year old men and women living in Western Siberia with metabolic syndrome (MS). The aim of the study is to study the features of the interrelationships of conventional and nonconventional risk factors for cardiovascular diseases (RF CVD), molecular genetic markers with the state of cognitive functions (CF), objective–subjective index of CF in an open population in persons aged 14–17, 25–44 years (Novosibirsk).Material and methods: A singlestage population survey of a random representative sample of 25–44 year olds of both sexes (1503 people) permanently residing in Western Siberia (Novosibirsk) was performed. The study of the state of cognitive functions was conducted in 1009 people: 463 men (45.9 %) and 546 women (54.1 %). The object of the study was random representative samples of the population of Novosibirsk, formed during the screenings of the NIITPM branch of the ICIG SB RAS. The paper uses materials from a one-stage population survey of adolescents (screenings 2009–2010 and 2019) and persons aged 25–44 years (screening 2013–2016). According to the methods standardized during the screening, the following were performed: a 10-word memorization test, a proof-reading test, and a concept exclusion test. Anthropometric measurements were carried out. Determination of the levels of lipid fractions was carried out according to standardized methods. Genotyping of rs2464196 HNF1A and rs11212617 ATM was carried out using real-time PCR.Results. In the examined samples of Novosibirsk residents aged 14–17 and 25–44 years, statistically significant negative associations of RF CVD with neurodynamic CF were observed. Proatherogenic conventional RF CVD had a negative impact on attention and thinking patterns (among the most significant were the content of total cholesterol (odds ratio (OR) 0.996; 95 % confidence interval (95 % CI) 0.993–1,000; p = 0.043), low density lipoprotein cholesterol (OR 0.994; 95 % CI 0.990–0.998; p = 0.002)). The factors reducing the risk of deterioration of CF in 25–44 year olds were the presence of higher education (OR 2,350; 95 % CI 1,442–3,828; p = 0.001), female (OR 2,068; 95 % CI 1,552–2,754; p < 0.0001). In the cohort analysis, it was revealed that the studied conventional RF CVD undergo statistically significant changes in the direction of their increase during adulthood over the past 5 years (p < 0.05). It was shown that metabolic syndrome (MS) occurred in every fourth person tested for CF (26.06 %), while the values of cognitive tests were higher in people without MS compared to those who were diagnosed with MS (p < 0,05). Smoking had a negative effect on the memory pattern, causing a deterioration in the memorization of words (OR 1,071; 95 % CI 1,012–1,133); (p = 0.017). The deterioration of memory, attention and thinking patterns in the presence of workplace stress and low professional status, – important unconventional RF CVD, – has been established (p < 0.05)).Conclusion. In the open population of adolescents and young people (25–44 years old), a statistically significant deterioration of cognitive patterns was found in the presence of the studied conventional and non-conventional RF CVD.

Cardiovascular risk in patients receiving antihypertensive drug treatment from the perspective of endothelial function.

Blood-pressure-lowering therapy with antihypertensive drugs can reduce the risk of cardiovascular morbidity and mortality in patients with hypertension. However, patients treated with antihypertensive drugs generally have a worse prognosis than untreated individuals. Consistent with the results obtained from epidemiological studies, a clinical study showed that endothelial function was impaired more in treated patients with hypertension than in untreated individuals with the same blood pressure level, suggesting that blood-pressure-lowering therapy with currently available antihypertensive drugs cannot restore endothelial function to the level of that in untreated individuals. Several mechanisms of endothelial dysfunction in treated patients are postulated: irreversible damage to the endothelium caused by higher cumulative elevated blood pressure exposure over time; the persistence of the primary causes of hypertension even after the initiation of antihypertensive drug treatment, including an activated renin-angiotensin-aldosterone system, oxidative stress, and inflammation; and higher global cardiovascular risk related not only to conventional cardiovascular risk factors but also to undetectable nonconventional risk factors. Lifestyle modifications/nonpharmacological interventions should be strongly recommended for both untreated and treated individuals with hypertension. Lifestyle modifications/nonpharmacological interventions may directly correct the primary causes of hypertension, which can improve endothelial function and consequently reduce cardiovascular risk regardless of the use or nonuse of antihypertensive drugs.

Analysis of conventional and nonconventional risk factors, clinical profile and angiographic correlation in young myocardial infarction

Analysis of conventional and nonconventional risk factors, clinical profile and angiographic correlation in young myocardial infarction

Day‐to‐day blood pressure variability and severity of COVID‐19: Is sympathetic overdrive a potential link?

Day‐to‐day blood pressure variability and severity of COVID‐19: Is sympathetic overdrive a potential link?

Oxidative Stress in Non-Dialysis-Dependent Chronic Kidney Disease Patients.

Background: Cardiovascular complications are the leading cause of morbidity and mortality at any stage of chronic kidney disease (CKD). Moreover, the high rate of cardiovascular mortality observed in these patients is associated with an accelerated atherosclerosis process that likely starts at the early stages of CKD. Thus, traditional and non-traditional or uremic-related factors represent a link between CKD and cardiovascular risk. Among non-conventional risk factors, particular focus has been placed on anaemia, mineral and bone disorders, inflammation, malnutrition and oxidative stress and, in this regard, connections have been reported between oxidative stress and cardiovascular disease in dialysis patients. Methods: We evaluated the oxidation process in different molecular lines (proteins, lipids and genetic material) in 155 non-dialysis patients at different stages of CKD and 45 healthy controls. To assess oxidative stress status, we analyzed oxidized glutathione (GSSG), reduced glutathione (GSH) and the oxidized/reduced glutathione ratio (GSSG/GSH) and other oxidation indicators, including malondialdehyde (MDA) and 8-oxo-2’-deoxyguanosine (8-oxo-dG). Results: An active grade of oxidative stress was found from the early stages of CKD onwards, which affected all of the molecular lines studied. We observed a heightened oxidative state (indicated by a higher level of oxidized molecules together with decreased levels of antioxidant molecules) as kidney function declined. Furthermore, oxidative stress-related alterations were significantly greater in CKD patients than in the control group. Conclusions: CKD patients exhibit significantly higher oxidative stress than healthy individuals, and these alterations intensify as eGFR declines, showing significant differences between CKD stages. Thus, future research is warranted to provide clearer results in this area.

Prevalence of hypertension among young men: fifteen-year trends

Objective. The aim of the study was to assess the changes in the prevalence of hypertension (HTN) among young men according to two screenings of independent samples of an open urban population.Design and methods. The study is based on two cross-sectional studies, over a fifteen year range, among males in the Central Administrative District of Tyumen. Representative samples were formed according to a single protocol from electoral lists among men 25–64 years old by the method of “random numbers” — 1000 people each (250 people each in four decades of life), the response was 79,5 % and 85,0 %, respectively, in the first and second screening. As part of cardiac screenings, the prevalence of HTN, mean values and percentile distribution for systolic and diastolic blood pressure (SBP, DBP) were determined in two groups of young age 25–34 and 35–44 years.Results. Young men of an open population of a moderately urbanized city of Western Siberia have high blood pressure (BP) levels with a significant increase in average levels and percentile distribution of SBP and DBP in the age range from the third to the fourth decade of life. According to the results of two cross-sectional studies in the range of fifteen years, we found a tendency towards a decrease in SBP and the prevalence of HTN in men in the third decade of life in an open population of a moderately urbanized city of Western Siberia. At the same time, the levels of SBP, DBP and the prevalence of HTN in the fourth decade of life remain stable.Conclusions. We found high levels of BP and the prevalence of HTN among young men in a medium-urbanized city of Western Siberia and a positive fifteen-year dynamics in reduced prevalence of HTN in young people. The latter is a favorable factor and opens up opportunities for targeted impact on other conventional and non-conventional cardiovascular risk factors in this age group.

Intestinal Chelators, Sorbants, and Gut-Derived Uremic Toxins

Chronic kidney disease (CKD) is a highly prevalent condition and is associated with a high comorbidity burden, polymedication, and a high mortality rate. A number of conventional and nonconventional risk factors for comorbidities and mortality in CKD have been identified. Among the nonconventional risk factors, uremic toxins are valuable therapeutic targets. The fact that some uremic toxins are gut-derived suggests that intestinal chelators might have a therapeutic effect. The phosphate binders used to prevent hyperphosphatemia in hemodialysis patients act by complexing inorganic phosphate in the gastrointestinal tract but might conceivably have a nonspecific action on gut-derived uremic toxins. Since phosphorous is a major nutrient for the survival and reproduction of bacteria, changes in its intestinal concentration may impact the gut microbiota’s activity and composition. Furthermore, AST-120 is an orally administered activated charcoal adsorbent that is widely used in Asian countries to specifically decrease uremic toxin levels. In this narrative review, we examine the latest data on the use of oral nonspecific and specific intestinal chelators to reduce levels of gut-derived uremic toxins.

Comparison of demographic profile, risk factors, and in-hospital outcome in young and old patients with acute coronary syndrome: A single-center experience.

Background:Coronary artery disease (CAD) is witnessing a demographic transition with increasing prevalence in younger individuals. Data is scarce comparing various characteristics of acute coronary syndrome (ACS) between young and old patients in an Indian setting. Hence, we evaluated the epidemiological, demographic, risk factor, and outcome profile of young and old ACS patients in Indian setting.Methods:This was a prospective observational study, which enrolled 50 consecutive ACS patients each into two groups: younger (≤45 years) and elderly (>45 years), respectively. Comparison of clinical presentation, electrocardiography, echocardiographic findings, conventional, nonconventional risk factors, and in-hospital outcomes including duration of hospital stay and major adverse cardiac events (MACE) were made between the two groups. Multivariate regression analysis of risk factors as determinants of MACE adjusting for other confounding factors was also performed.Results:Fifty patients in each group were compared. Mean age in the younger and elderly group was 36 ± 4.69 and 61.58 ± 10.69 years, respectively. Male sex, smoking, family history of CAD, hyperhomocysteinemia, and obesity were observed more in the younger population. While dyslipidemia, low physical activity, diabetes mellitus, and history of previous ACS was more in the older population. Single-vessel disease was more common in younger patients while multivessel involvement was more common in elderly patients. Older patients had longer hospital stays and more in-hospital MACE including deaths. By multivariate analysis, shock was found to be an independent predictor of MACE in both groups.Conclusion:Younger ACS patients have a different risk profile and better in-hospital outcomes compared to older patients.

RISK ASSESSMENT OF NON-CONVENTIONAL CONTRIBUTORY FACTORS IN ONSET OF DIABETES MELLITUS TYPE II

The aim of current study is the risk assessment of biochemical variables of medical importance, vitamin D and calcium, in pathogenesis of Diabetes Mellitus Type II (T2DM) human beings and the risk assessment due to variation of these biochemical variables in diabetic patients. One hundred subjects (n=100) were recruited from different hospitals in Lahore (31.5204° N, 74.3587° E) after taken informed consents individually. This study was approved by the ethical committee of Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore. Subjects were equally divide in two groups; diabetic (case group; n=50) and non-diabetic (control; n=50). Calcium and vitamin D levels were measured by the biochemical laboratory of Hospitals. Finally the data was statistically analyzed by using SPSS software (Version 16). A total of 52 % males and 48 % females were investigated for changes in serum calcium and vitamin D in relation to their biochemical importance in Diabetes Mellitus. Both calcium and vitamin D levels were significantly low in diabetic group (p=0.003 and p=0.001 respectively) as compare to control group. Persons correlation showed calcium and vitamin D were directly proportional to each other (R2= 0.577). Odds ratio showed that the low vitamin D and low Calcium levels were 3.47 and 3.17 time more prevalent in diabetic group as compare to the non- diabetic group. Diabetes Mellitus is an increasing health issue in world causing severe morbidity and mortality. So it is important to investigate the non-conventional risk factors of Diabetes Mellitus. Thus, the current study illuminates the risk assessment of altered levels of vitamin D and calcium, their possible pathogenesis in Diabetes Mellitus. It can be concluded from this study that supplementation of vitamin D and calcium till to the normal physiological limits can help not only lowering the risk of diabetes but may also prevent its progression.

Ischemic heart disease in women: Non-conventional risk factors and in-hospital outcomes in a coronary care unit in a cardiovascular hospital in Argentina

Background and Aims: Ischemic heart disease is the leading cause of mortality in women globally. Therefore, it is important to identify non-conventional risk factors present in this population and their impact in cardiovascular outcomes.

HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p>0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p>0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p>0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p<0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p<0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

Parameters of stressful events at a young age (data of cross-sectional epidemiological studies)

Aim. To determine the parameters of family and work stress in the open population of the medium urban city of Western Siberia among young men and women.Material and methods. The study of nonconventional (psychosocial) risk factors for coronary artery disease was carried out according to the WHO program “MONICA-psychosocial” using the standard “Knowledge and attitude to your health” questionnaire. Family and work stress was determined by a face-to-face interview.Results. Stress in the family among young people in the medium urban city of Western Siberia was manifested mainly by the loss or severe illness of relatives, family conflicts; in men as well — a change in marital status, in women — lack of home rest. Stress at work was manifested mainly in high or low workplace responsibility; in men as well — in changing occupation, increasing workload and responsibility over the past year, changing job, in women — in the change of manager, lack of home rest among working women.Conclusion. Consequently, the sex characteristics of psychosocial risk factors for cardiovascular diseases, regarding chronic social stress factors, are even more significant, which specifies the need for a further study of psychosocial factors, and thereby the possibilities for changing the epidemiological situation of cardiovascular diseases in region. This also confirms the need for future research on the relationships of psychological disorders with cardiovascular diseases.

Prevalence of non-conventional risk factors among patients with chronic obliterating diseases of lower limb arteries

Objective: to study the prevalence of non-conventional risk factors among patients with chronic obliterating diseases of lower limb arteries.Material and methods. To identify the non-conventional risk factors among patients, the Hospital Anxiety and Depression Scale (HADS), DS-14 questionnaire were used. The survey included 250 patients with chronic obliterating diseases of lower limb arteries (men - 192 patients (76.8 %), women - 58 (23.2 %). The statistical analysis of the data was carried out by means of the program «Statistica» 8.0. Differences between the groups were considered as statistically significant at p < 0.05.Results. Anxiety symptoms were observed in 53.2 % of the patients. The average HADS-A subscale score was 8.0 (5.0; 9.0) points. Symptoms of hospital depression were observed in 38.4 % of the patients. The average HADS-D subscale score in all the patients was 6.0 (4.0; 9.0) points. Personality type D was detected in 51.2 % of the patients.